Provider Demographics
NPI:1063577138
Name:WALID S ARNAOUT MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:WALID S ARNAOUT MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALID
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNAOUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-379-9696
Mailing Address - Street 1:18250 ROSCOE BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4271
Mailing Address - Country:US
Mailing Address - Phone:818-280-3901
Mailing Address - Fax:805-379-9695
Practice Address - Street 1:18250 ROSCOE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4271
Practice Address - Country:US
Practice Address - Phone:818-280-3901
Practice Address - Fax:805-379-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A53180Medicaid
CA00A53180Medicaid